Head and neck osteosarcomas: Analysis of treatment trends and survival outcomes in the United States (2004–2016)

Shim, Timothy; Chillakuru, Yeshwant; Darwish, Christina; Chalif, Eric; Strum, David P.; Benito, Daniel A.; Mulcahy, Collin F.; Monfared, Ashkan

doi:10.1002/hed.26817

Cited by 14 publications

(12 citation statements)

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“…The Memorial Sloan Kettering Cancer Center’s experience for head and neck osteosarcomas could not conclusively confirm improved tumor local control, decrease presence of distant metastases or improved disease-specific survival with the addition of neoadjuvant chemotherapy to conventional treatment. Furthermore, they suggest that the bone architecture of the tumor does not allow the mass to ‘shrink’ [ 7 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Poorly differentiated sarcoma of the maxillary sinus: a histopathology dilemma of a rare tumor

Simunjak

Šimunjak

Jurlina

et al. 2022

Journal of Surgical Case Reports

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Sarcomas are a rare heterogeneous group of neoplasms of mesenchymal origin. In the redistribution of all head and neck malignancies, sarcomas are represented by only 1%. Herein, we report a case of a 66-year-old patient with right maxillary sinus sarcoma that spread through the ostiomeatal complex, infiltrated the septum, all ethmoid cells, frontal sinus, involved the entire right nasal cavity and penetrated to the nasopharynx. Patient was treated with neoadjuvant chemotherapy, surgery and adjuvant radiotherapy. The histopathology indicated poorly differentiated sarcoma with elements of Ewing’s sarcoma, but also with elements consistent with osteosarcoma. Molecular pathological analysis excluded Ewing's sarcoma. Samples were also sent for review to the other Pathology Clinics. They suggested poorly differentiated high-grade pleomorphic sarcoma with elements of osteosarcoma. The accurate diagnosis of the head and neck sarcoma type can be a histopathology dilemma posing a great challenge in the choice of therapeutic approach, and thus the treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Poorly differentiated sarcoma of the maxillary sinus: a histopathology dilemma of a rare tumor

Simunjak

Šimunjak

Jurlina

et al. 2022

Journal of Surgical Case Reports

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“…Also very important is the study by Shim et al Shim et al analyzed data from 821 patients with COS from the National Cancer Database (NCDB) and compared 9 treatment cohorts with each other (surgery only, neoadjuvant chemotherapy + surgery, surgery+ adjuvant chemotherapy, neoadjuvant chemotherapy + surgery + adjuvant chemotherapy, surgery + adjuvant radiotherapy, surgery+ chemoradiation, chemoradiation, radiotherapy, and no treatment) (32). Shim et al failed to show an overall survival benefit with chemotherapy (neoadjuvant or adjuvant), radiotherapy, or a combination of these therapies (32).…”

Section: Impact Of Therapeutic Intervention On Survival Rates In Pati...mentioning

confidence: 99%

“…Interestingly, patients treated with neoadjuvant chemotherapy + surgery + adjuvant chemotherapy showed a survival advantage in the first 18 months compared to patients treated with surgery alone (95.8% vs. 78.5%). However, no long-term survival benefit could be achieved with chemotherapy or radiotherapy (32).…”

Section: Impact Of Therapeutic Intervention On Survival Rates In Pati...mentioning

confidence: 99%

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Systematic review of craniofacial osteosarcoma regarding different clinical, therapeutic and prognostic parameters

et al. 2023

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BackgroundOsteosarcomas are the most common primary bone tumor while occurrence in the craniofacial skeleton is relatively rare. There are clinical differences of osteosarcomas regarding their location. In this regard craniofacial osteosarcomas (COS) have special characteristics. Extracranial osteosarcomas (EOS) occur mainly in the long bones of the extremities (tibia, humerus and femur). These tumors metastasize hematogenically at a very early stage. In comparison, COS are mainly localized in the mandible and maxilla, occur later in life and show significantly less and later metastasis and respond differently to adjuvant therapy. In the literature, clinical characteristics of COS and EOS are rarely compared directly. The aim of this systematic review is to answer the question whether COS and EOS exhibit fundamentally different clinical behavior and how they differ in terms of survival rates and response to different therapies.MethodsA systemic review was performed. Pubmed, Cochrane and Google Scholar were used as search engines. The literature research was done by using clearly defined terms and their links. 124 full texts were selected and evaluated for this review. The inclusion criteria were determined using the PICO model.ResultsCOS have significantly better survival rates, especially if they are located in the jawbone. Surgical R0 resection is crucial for therapeutic success. The study situation regarding the benefit of neoadjuvant chemotherapy in COS is very inhomogeneous. There is also no evidence for the benefit of adjuvant radio- or chemotherapy in COS. The large heterogeneity of the studies in terms of therapeutic concept, initial situation of the patients and outcome considered, as well as the small number of patients with craniofacial osteosarcoma were limiting factors.ConclusionThe results of this study show the clear therapeutic and prognostic differences between COS and EOS and underline the necessity to consider both types of osteosarcoma as independent tumor entities in future studies. Furthermore, the study highlights the importance of surgical R0 resection for the prognosis of COS patients. There is no evidence for therapeutic benefit of adjuvant/neoadjuvant radio-/chemotherapy in R0 resected COS cases.

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Comment to: “Head and neck osteosarcomas: An analysis of treatment trends and survival outcomes in the United States (2004–2016)”

2021

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Rs e e p a g e 4 0 2 0 -4 0 2 1 Comment to: "Head and neck osteosarcomas: An analysis of treatment trends and survival outcomes in the United States (2004States ( -2016"We read, with great enthusiasm, the article by Shim et al., reporting the survival analysis of 821 patients diagnosed with head and neck osteosarcomas (HNOSs) from the National Cancer Database. 1 We would like to acknowledge the authors for this effort, which reflects the conflicting results regarding the benefits of neoadjuvant chemotherapy (neoCT). The authors concluded that "short-term survival improvement in patients receiving both neoadjuvant and adjuvant chemotherapy displays promise." We would like to bring some precisions regarding this conclusion. While large, the studied cohort is retrospective and heterogeneous. Indeed, patients who have received neoCT (108/841) had significantly more mandible, pT1, nonmetastatic, and early American Joint Committee on Cancer (AJCC) stage tumors, which are known to be easier resectable as shown by the significant higher rate of negative surgical margin in these patients. Nevertheless, we recently reported that small tumor size and R0 (clear margins) surgical resections are significantly and independently associated with better outcomes for HNOS patients. 2 Beside these biases, no significant result is shown in all the Cox regression models. Moreover, pathological response to neoCT (>90% of tumor cell necrosis), which has been previously reported to be significantly associated with better overall survival (OS), 3 is not evaluated in the Shim et al. study. Of note, less than 30% of HNOS patients achieve good histological response after neo-CT 4 and no significant benefit of neoCT on OS has been reported in recent large series. 5,6 In the present study, the primary outcome was OS while comparing disease-free survivals between neoCT versus non-neoCT HNOS patients seems to be more relevant to assess the benefit of such treatment, especially when their using is still debated. Finally, the authors discuss results published by the Canadian Society of Otolaryngology 6 (35 HNOS patients) and stated that the reported trend toward improved early survival with adjuvant chemotherapy "may be due in part to benefits of neoCT in decreasing the confines of the tumor allowing for a more complete surgical resection." However,

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Head and neck osteosarcomas: Analysis of treatment trends and survival outcomes in the United States (2004–2016)

Cited by 14 publications

References 27 publications

Poorly differentiated sarcoma of the maxillary sinus: a histopathology dilemma of a rare tumor

Poorly differentiated sarcoma of the maxillary sinus: a histopathology dilemma of a rare tumor

Systematic review of craniofacial osteosarcoma regarding different clinical, therapeutic and prognostic parameters

Comment to: “Head and neck osteosarcomas: An analysis of treatment trends and survival outcomes in the United States (2004–2016)”

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